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Spatial disparities in hospital performance

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  • Laurent Gobillon
  • Carine Milcent

Abstract

Spatial disparities in mortality can result from spatial di¤erences in patient characteristics, treatments, hospital characteristics, and local healthcare market structure. To distinguish between these explanatory factors, we estimate a flexible duration model on stays in hospital for a heart attack using a French exhaustive dataset. Over the 1998-2003 period, the raw disparities in the propensity to die within 15 days between the extreme regions reaches 80 %. It decreases to 47% after taking into account the patients' characteristics and their treatments. We conduct a variance analysis to explain regional disparities in mortality. Whereas spatial variations in the use of innovative treatments play the most important role, spatial di¤erences in the local concentration of patients also play a significant role.

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Bibliographic Info

Article provided by Oxford University Press in its journal Journal of Economic Geography.

Volume (Year): 13 (2013)
Issue (Month): 6 (November)
Pages: 1013-1040

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Handle: RePEc:oup:jecgeo:v:13:y:2013:i:6:p:1013-1040

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References

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  1. Ghatak, Maitreesh & Mueller, Hannes Felix, 2010. "Thanks for Nothing? Not-for-Profits and Motivated Agents," CEPR Discussion Papers 7663, C.E.P.R. Discussion Papers.
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Cited by:
  1. MORIKAWA Masayuki, 2010. "Economies of Scale and Hospital Productivity: An empirical analysis of medical area level panel data," Discussion papers 10050, Research Institute of Economy, Trade and Industry (RIETI).
  2. Badi H. Baltagi & Yin-Fang Yen, 2014. "Hospital Treatment Rates and Spill-Over Effects: Does Ownership Matter?," Center for Policy Research Working Papers 165, Center for Policy Research, Maxwell School, Syracuse University.
  3. Badi H. Baltagi & Yin-Fang Yen, 2014. "Hospital Treatment Rates and Spillover Effects: Does Ownership Matter?," CESifo Working Paper Series 4664, CESifo Group Munich.

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